Fever

Fever, also called pyrexia, abnormally high bodily temperature or a disease of which an abnormally high temperature is characteristic. Although most often associated with infection, fever is also observed in other pathologic states, such as cancer, coronary artery occlusion, and disorders of the blood. It also may result from physiological stresses, such as strenuous exercise or ovulation, or from environmentally induced heat exhaustion or heat stroke.

Under normal conditions the temperature of deeper portions of the head and trunk does not vary by more than 1–2 °F in a day, and it does not exceed 99 °F (37.22 °C) in the mouth or 99.6 °F (37.55 °C) in the rectum. Fever can be defined as any elevation of body temperature above the normal level. Persons with fever may experience daily fluctuations of 5–9 °F above normal; peak levels tend to occur in the late afternoon. Mild or moderate states of fever (up to 105 °F [40.55 °C]) cause weakness or exhaustion but are not in themselves a serious threat to health. More serious fevers, in which body temperatures rise to 108 °F (42.22 °C) or more, can result in convulsions and death.

During fever the blood and urine volumes become reduced as a result of loss of water through increased perspiration. Body protein is rapidly broken down, leading to increased excretion of nitrogenous products in the urine. When the body temperature is rising rapidly the affected person may feel chilly, or even have a shaking chill; conversely, when the temperature is declining rapidly the person may feel warm and have a flushed moist skin.

In treating fever, it is important to determine the underlying cause of the condition. Mild and moderate fevers are best treated by aspirin or other antipyretic drugs, which exert their effect on the temperature-regulating areas of the brain.

The mechanism of fever appears to be a defensive reaction by the body against infectious disease. When bacteria or viruses invade the body and cause tissue injury, one of the immune system’s responses is to produce pyrogens. These chemicals are carried by the blood to the brain, where they disturb the functioning of the hypothalamus, the part of the brain that regulates body temperature. The pyrogens inhibit heat-sensing neurons and excite cold-sensing ones, and the altering of these temperature sensors deceives the hypothalamus into thinking the body is cooler than it actually is. In response the hypothalamus raises the body’s temperature above the normal range, thereby causing a fever. The above-normal temperatures are thought to help defend against microbial invasion because they stimulate the motion, activity, and multiplication of white blood cells and increase the production of antibodies. At the same time, elevated heat levels may directly kill or inhibit the growth of some bacteria and viruses that can tolerate only a narrow temperature range.